Hallux valgus is a more common disease in children and women and is orthopedic in nature. It is distinguished by the curvature of the shaft of the leg, when its middle part descends and thickens. In addition, a deformity of the thumb, a characteristic hump, and muscle-ligament balance may appear.
Other names for the disease: hallux valgus, hallux valgus.
Main symptoms: pain, fatigue when walking, bending of the foot axis.
The treatment is carried out by an orthopedic traumatologist.
An article for patients with a disease diagnosed by a doctor. It does not replace a doctor's appointment and cannot be used for self-diagnosis.
Causes
Valgus deformity of the feet almost always has a complex nature of formation. In most cases, there are combinations of the following prerequisites for this:
- Flat feet, congenital and acquired. As a result of its presence, weight and pressure are distributed unevenly, which leads to deformation of the fingers.
- Osteoporosis, which is characterized by loss of bone stiffness and low calcium content.
- Obesity, excess weight, which causes excessive stress on the bone, especially with muscle weakness.
- Hereditary predisposition, when the ligaments are weak, as well as the characteristic changes in the foot - hallux valgus - can be predetermined genetically.
- Wearing the wrong shoes. The problem often appears in women due to walking in uncomfortable and tight shoes with high heels. In this case, the correct load on the foot is disrupted and the likelihood of hallux valgus deformity increases.
- Injuries, for example, a heavy object falling on the foot, a fracture or bruise can result in foot deformity.
- Associated diseases of the endocrine system, neurological nature.
- Sharp fluctuations in hormones, including during menopause, during pregnancy, as well as during the natural course of the menstrual cycle.
Hallux valgus can occur for any of these reasons, as well as for a combination of them. However, it is not always possible to objectively determine the exact basis for the development of hallux valgus. In this case, the greatest emphasis is placed on a course of therapy.
Phases and forms
One of the main criteria for assessing the severity of foot deformity in children and adults is the angle at which the big toe deviates. The larger it is, the more serious the degree of pathology. According to her:
- Phase I -15°;
- II - 20°;
- III - 30°;
- IV - more than 30 °.
To fully assess the degree of hallux valgus deformity not only of the first toe, but also of the hind toe. There is a classification that is based on the installation of the heel in relation to the axis of the foot:
- Stage I - the presence of flat feet, but a slight deviation up to 15 °;
- II - up to 23 °;
- III - up to 30 °;
- IV - the leg becomes completely flat, the deviation is more than 30 °, which is considered a severe form.
In general, according to the severity of the situation and the degree of curvature, the following types of the nature of the course of the disease are distinguished:
- lungs;
- average;
- heavy.
Due to the formation, foot deformities are divided into the following types:
- structural, which is caused by congenital pathology;
- static, caused by the curvature of the spine;
- spasticity, resulting from muscle tension or tone;
- traumatic deformation of the leg;
- rachitic and others.
Thus, there are many types of deformities of the first toe and other parts of the foot. To determine the characteristics of the course of the disease, it is necessary to consult a doctor and undergo examinations.
Symptoms
The special cunning of the pathology lies in the fact that it does not appear for a long time. Often a person simply does not notice warning signs, including the formation of calluses in the same places, a quick feeling of fatigue after walking. Visible problems begin only after the disease reaches a more serious stage, which complicates the treatment and makes it longer.
Manifestations of hallux valgus can vary and include the following:
- fatigue while walking;
- corn;
- corns that appear regularly, repeatedly in the same places;
- pain;
- increased swelling of the lower extremities;
- deviation of the thumb to the side;
- the formation of a characteristic bump, which is often called a "finger bone";
- deformity of the remaining fingers, which become hammertoes.
As the foot deformity progresses, the patient notices that the shoes he was wearing before no longer fit him. It becomes tight and uncomfortable as a result of increased tissue thickening, the appearance of new calluses and increased bursitis.
Finding shoes becomes difficult, sometimes almost impossible. In the advanced stages of hallux valgus, the pain constantly intensifies, increases, discomfort is observed in the knee and hip joints, and the load on the spine increases. In the first stage of hallux valgus and other parts of the foot, the patient is usually only concerned about a cosmetic problem.
Complications
One of the terrible consequences of the lack of therapy is not only the progression of the pathology, but also the increase of other problems related to it. With the development of hallux valgus, negative consequences can occur. The most common are these:
- Bursitis, namely inflammation of the synovial bursae. This problem is expressed by swelling and pain in certain areas of the leg as a result of deformities of the ankles.
- Arthrosis is the destruction of cartilage, which leads to reduced joint mobility, pain and gait disorders.
- Increased load, due to which the knee joint wears out, the pressure on the spine increases and arthrosis appears.
- Formation of a heel spur. In this case, a sharp, almost unbearable pain appears while walking.
- Achilobursitis and other diseases.
In addition, hallux valgus always presents a serious aesthetic problem, which is especially noticeable when wearing open shoes. This causes a person great psychological distress, which can negatively affect his general psycho-emotional state.
To avoid negative consequences, it is necessary to undergo treatment in time. The medical center employs experienced doctors who help patients with any form and degree of valgus.
Diagnosing
At the initial meeting, the orthopedist-traumatologist performs a complete examination and examination of the patient. To do this, he visually assesses the condition of the legs, their location, deviations and determines the presence of deformity of the front leg. However, this is not enough to draw a definitive conclusion about the extent and nature of the problem, so additional studies are warranted.
Instrumental methods
One of the main ways to evaluate hallux valgus is radiography in three projections. This allows not only the identification of this problem, but also the identification of a number of others, including subluxations, dislocations and arthrosis. Based on the results of this examination, it is possible to estimate the size of the angle deviation, make calculations and correctly prescribe a course of treatment for hallux valgus.
For a more detailed study of hallux valgus deformity or, if necessary, additional studies are prescribed:
- Ultrasound can make it possible to identify disturbances in the functioning of blood vessels if problems with local circulation are suspected.
- Computed tomography or magnetic resonance will help to exclude other pathologies similar to hallux valgus and to get a more detailed picture of the disease.
- Plantography, which allows you to identify and determine the degree of flat feet.
- Podoscopy is an examination of the foot in a standing position.
There are no specific methods of laboratory research for the diagnosis of hallux valgus in adults and children. Usually the listed examination methods are sufficient, but if necessary, the doctor can prescribe others.
Hallux valgus can resemble other diseases, making the differential diagnosis particularly important. Among the most common are:
- gout;
- osteoarthritis;
- arthritis.
The modern medical clinic has the latest diagnostic equipment. This allows you to quickly identify hallux valgus and carry out a complete examination and therapy.
Treatment of hallux valgus
Today, specialists have a number of methods to help patients with foot deformities. Even the first phase of therapy may vary depending on the characteristics of a particular case. If the degree of the disease is already severe, hallux valgus in adults sometimes begins immediately with surgical intervention.
Conservative methods
There are many ways and techniques that help to avoid surgical treatment, especially in the initial stages of the development of the pathology. Among the most common are the following:
- Wearing orthopedic shoes. It should be rigidly fixed, with a stable and low heel and an elongated toe. In addition, special insoles, supports, and other devices can be used to remove excess load from the metatarsal bone. It is important to understand that such treatment for hallux valgus is usually long-term and lasts more than six months, sometimes even a year.
- Physical therapy classes. The exercise therapy instructor selects a program for a specific patient and also teaches the proper technique for performing the exercises. It is important to consult a specialist at the first stage.
- Foot massage. It should be done only in specialized medical centers, as it aims not so much at relaxation, but at the treatment of valgus.
- Taking non-steroidal anti-inflammatory drugs, both to reduce the inflammatory process and to relieve pain. It is important to consult a doctor before using such medicines.
- Proper nutrition, calcium-enriched diet.
In addition, the use of physiotherapeutic procedures in the treatment of hallux valgus is useful, which may include:
- phonophoresis;
- UHF;
- magnetic therapy.
During the treatment of hallux valgus, it is recommended to avoid prolonged standing and focus your efforts on strengthening the muscles and ligaments.
All these methods for the treatment of hallux valgus can be used in combination or separately. The course is developed by the doctor depending on the situation and complexity of the particular case. However, they are more suitable for treating patients with early-onset hallux valgus or early-stage hallux valgus.
Surgical methods
If conservative treatment of foot deformities is ineffective, or if the problem is detected at a late stage, surgery is performed. It has its advantages, since the problem is solved in one stage, while with non-surgical treatment of deformities of different parts of the leg, this often lasts for several years.
Today, doctors perform appropriate manipulations, which have many varieties. It depends on what kind of procedure will be important for a particular patient. According to this criterion, operations for the correction of hallux valgus are divided into the following:
- In soft tissues. In this case, the treatment of hallux valgus in children and adults in the early stages of the development of the pathology can be the use of the Silver and McBride technique. They are relevant only for stage I of the disease.
- A combination of effects on bone structures and soft tissues to treat foot deformities, for example, Schede's operation.
- On the bones. This type of intervention is called osteotomy, which has many varieties. It is most often used for moderate to severe foot deformities in adults.
Modern methods of surgical treatment of patients with foot deformities allow, in many cases, the intervention to be performed percutaneously or using a laser, for example, the "bone" reappearance for hallux abducto valgus. If it is possible to carry out a minimally invasive type of therapy for hallux valgus deformities, the advantages are obvious:
- quick rehabilitation period;
- lack of cuts and large seams;
- eliminating the need for long-term hospitalization;
- low risk of complications.
The goal of any type of intervention is to bring the foot closer to its natural and normal state. However, the doctor takes into account the individual structure of the patient's feet, as it is unique.
Recovery after surgery for the correction of hallux valgus requires different times: from 2 weeks to 4 months, depending on the extent of the intervention and its complexity. During the recovery period, you will need to wear special shoes, follow the doctor's recommendations and use medications.
Features of treatment in children
Parents are often the first to notice hallux valgus in children. If it appears early, it becomes apparent around one year of age, when the child begins to walk. Sometimes a pediatrician notices a deviation and can point it out and refer you for a consultation with an orthopedist.
If you consult a doctor at the right time, the situation can be corrected using conservative methods of therapy. If the baby's arch is in a valgus position, in most cases the problem can be solved without surgery.
If at a young age, during the placement of the legs, a valgus curvature is formed, massage, physiotherapy and physiotherapy are used. However, one of the main ways to correct the situation is to wear orthopedic shoes. It is selected individually, as the child grows and the angle of the foot changes, it must be replaced.
Surgical treatment is used extremely rarely, and the question of its choice is always treated individually. With a small degree of damage, they try not to use radical treatment.
The prognosis for the treatment of deformities of the first toe and valgus in general in children is often positive. If you follow all the doctor's recommendations and systematic observation, it is possible to completely restore the normal appearance and functionality of the leg.
Which doctor is treating you?
The treatment of hallux valgus is traditionally carried out by an orthopedic traumatologist. It is this specialist who will help the patient if the first symptom of the disease is noticed or for prevention purposes. In the case of illness in children, the specialist should have skills and experience in managing such patients. If radical treatment of hallux valgus is necessary, the participation of a surgeon will be required.
PREDICTION
With proper and timely therapy, the hallux valgus deformity can be successfully eliminated. In most cases, it is possible to stop the pain and achieve the desired aesthetic effect. The therapy is particularly successful in young children, as well as at an early stage of the problem's development.
However, this is possible if you follow all the recommendations of the specialist, as well as in case of early diagnosis. In severe situations, the treatment of hallux valgus is also possible, but it will take longer and will involve the use of more serious methods of intervention. There is a risk that it will not be possible to completely restore the original condition of the leg in particularly advanced cases.
Preventing
There are no reliable ways to definitively prevent hallux valgus. It is multifactorial in nature and is often due to genetic predisposition. However, there are a number of ways to reduce the risk of its occurrence or to eliminate it at an early stage of development:
- regular preventive examination by an orthopedist-traumatologist;
- timely detection and treatment of flat feet;
- wearing comfortable shoes, excluding stiletto heels for women;
- if necessary, the use of orthopedic insoles;
- weight control, keeping it in a normal, optimal state;
- compliance with rest and work standards, especially if a person's professional activity is accompanied by increased stress on the legs;
- proper and balanced food, giving up bad habits;
- a moderate level of physical activity, which means the absence of physical inactivity and excessive stress on the legs.
In a modern medical center you can undergo modern diagnosis and treatment of hallux valgus at any stage of its development.